An Anxious Person's Opus to Life Without Anxiety Medication

Stressed out. Racing. Panicked. Nervy B. Sunday scaries. The dreads. Merr... We all have different ways of labeling our anxiety but here at ELLE.com we all suffer from it in varying degrees. So in advance of the holiday season, a time that can be particularly fraught with anxiety, we're talking about it.

I was having a heart attack. That was the only explanation for it.

It was hard to breathe, and the edges of my vision were blurring out, like someone was using a special fading lens on my eyes, but my heart beat—heavy, fast, throbbing painfully through my neck and ears and turning the space behind my eyes red at regularly irregular intervals—was the worst part.

Trying not to shake visibly, I stood up from my desk, ignoring the white noise roar in my ears. I was not going to collapse in front of all my classmates; I just needed to get out of the door without letting them know that I was dying.

That, in itself, would be so mortifying that it might kill me all over again.

Out in the hall, I plopped onto the cold stone window ledge, dropped my bag to the floor, and stuck my head down between my knees.

Boom. Boom. Boom. The thumping in my chest, sending shockwaves through my body, started to recede slightly. The longer I sat there, motionless, alone, the softer it got. Eventually, I could almost breathe normally.

I could walk to the nurse now. But what would I tell her? "I was having a heart attack I think, but it stopped?" All she would do was tell me to lie down in the back and feed me Dixie cups of ginger ale until my mom came to pick me up. But that didn't sound that appealing, actually: I was the kind of kid who urged my parents to come home from vacation a day earlier so I wouldn't miss as much school.

It would be fine. I'd tell my mom about it later. For now, I had to go back in and learn how to conjugate the past tense.

***

Spoiler alert: I was not having a heart attack. According to the EKG from the cardiac specialist I insisted my mom take me to, I didn't even have an arrhythmia. My heart was normal.

It was my brain that was fucked.

Those were the first anxiety attacks I ever had, but since then, I've had hundreds. I've never really been able to determine what sets one off—I can be under insane stress and go weeks without one, or I can have a day where, for no particular reason, with no cause in sight, I feel like a nerve-ending ocean, attacks rolling through me like waves, some higher, some lower, but the tide never quite receding fully.

Part of the reason for that is that I do not, and have never, taken medication to help regulate the Neurotic's Bundled-Services Package I got signed up for at birth (add OCD and depression with no extra changes to your genes).

I'm Midwestern—Minnesotan, to be precise—a land that prides itself on "Minnesota Nice," an attitude that basically compels you to smile regardless of what you're really thinking or feeling. It also forbids you from thinking you've got it bad ("Well sure, my lungs feel like someone wrapped about 100 rubber bands around them, but there are people out there with real problems, dontja know—now who wants more casserole?").

And beyond that, the idea of medication terrifies me.

I don't really like the inside of my head, much, but the idea of reshaping its entire landscape just to escape a few minutes of physical discomfort (or the need to realign everything at perfect right angles) has never seemed worth the risk.

What if my sense of humor disappears and I become an updated Stepford-bot? What if my writing isn't any good anymore? Or what if—and this actually seems plausible to me, though it's probably my disorders talking—my sense of constant, nervous dissatisfaction, the pervasive, essentially uninterrupted feeling of failure even in the midst of a win, is the thing that drives me to create in the first place?

What would I be if all that went away?

I've been jerry rigging solutions for almost two decades, now. I think at this point the better part of my personality, in fact, is those solutions.

As perverse as it sounds, my anxiety-OCD-depression bundle feels safer.

***

I think it's easier for me to make this decision because, on a scale from "normal" to "crippling," none of my issues have ever really been that bad.

No, that's not just my Minnesotan showing.

Sure, sitting up nights in high school, scratching an inch-wide hole in your own arm with your fingernails, or replacing most meals with either Diet Coke or chocolate milk for several years, or not being able to focus on the program on TV if you know the volume isn't set to a multiple of five, isn't exactly normal. But I've never been non-functioning. I've never attempted anything irreversible, been institutionalized against my will, or been unable to hold a job. In the cosmic scheme of mental illness, I've always had it easy.

My dad had it tougher, at least on the anxiety front. He once described his first attack to me: The general outline of symptoms was the same as my own—heart, lungs, guts, pain—but they were all ramped up enough that he actually collapsed to the floor in the middle of open court.

Even the first time it happened, I had the ability to stand up and walk out of the room to try to deal with things. Whether it's because my attacks have gotten less intense over time, or—as I suspect—that I've become so used to just letting them happen to me that their relative intensity is no longer a factor, I'm able to continue doing what I'm doing about 90% of the time I'm having an attack.

And no one around me will know it's happening.

I've managed to MacGyver all my disorders this way, which could mean I'm right, I don't really "need" medication…or it could mean I'm a neurotic version of a functioning alcoholic, and I'm utterly delusional about the depth of my own problems.

***

Photo: Getty Images

But that doesn't mean I'm not trying.

Here are some of the coping mechanisms I've tried over the years, and their (informal) success rates:

Deep, measured breathing: works sort of, sometimes, if you have nothing else you have to do, which is never

Exercise: this is the Tums of my anti-anxiety efforts, minimally effective after the fact, but not preventative

Therapy: the thing I have to guiltily admit that I have never maintained regularly enough, or long-term enough, to know whether it might help

Leaving wherever I am: helps with the immediate claustrophobia, hurts with the long-term "feeling like a normal person who has actual friends" part

Changing my diet: problematic, since like many of my fellow-sufferers, eating disorders are part of the grab-bag of fun

Ignoring the problem: my personal favorite, and the one thing that keeps other people from knowing I'm probably wincing every time they blithely step on sidewalk cracks

***

Regardless of whether or not I'm "right" about the current state of my disorders, I can say with confidence that things would need to be much, much worse before I'd concede to taking meds.

Part of that is the Catch-22 of having this particular series of issues: the disorders themselves, at least for me, are hugely about control; medication would be abdicating my control over my own mental space (weak though that clearly is) to some outside force. I wouldn't be holding the reins anymore, Paxil or Cymbalta or Klonopin or Xanax would be doing that for me. I'd have to be okay with the back seat.

And I'm not. Which probably means not taking meds is itself a symptom of my overarching network of neurosis. Refusing medication is just another tic. Like the disorders themselves, though, the abstention also comes from my dad.

If there was a medication that promised to fix one of his problems, physical or otherwise, he'd take it. It always made me—the meticulous, nervous, cross-every-t-ace-every-exam daughter—livid. Rather than make an effort to change a bad habit, he'd change the composition of the massive pillboxes that sat on the kitchen counter and his bathroom vanity. Poof. Problem solved.

Except it rarely was. And then what do you do when that pill stops working? When your nerves finally win out over your dosage?

You up the dosage, right?

I'm terrified of being dependent on something in that way, which is probably tied inextricably to the very disorders I would be trying to fix.

But I can't see what the world would look like from the other side of meds, just from this side.

I'll take the stomach aches and kettledrum pulse instead of that bet, thanks.

***

"It's a non-clinical dose, it won't act as an anti-depressant," the doctor told me for the third time. "At these levels, it will be just enough to…slow you down." My doctor—by which I mean my general practitioner—has already begun writing my name and the medication on her little pad. The pill she's suggesting isn't for my brain, despite being a now-obsolete anti-depressant. It's for my guts and heart. Both of them move too fast, most of the time; a normal day requires multiple trips to the bathroom and involves a resting heart rate more appropriate to hummingbirds than relatively fit humans. "You're sure?" I ask, watching her face for any hint of deception.

"I'm positive. I gave it to another patient who was having the same symptoms, and it's worked wonders. This won't affect anything but your stomach. And the dose is low enough that you don't have to worry about starting and stopping; you can do a couple weeks on and a couple off, or try it for a month then quit. There won't be any side effects."

I nod, taking the prescription from her, forcing a smile that I hope looks genuine.

But I won't fill it. The idea of what could happen makes me too anxious.

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